Breast Revision

Before And After Photos


This is a 43 year old mother of two who is 5’1″ and 143 pounds interested in a breast revision. She had a previous breast augmentation done elsewhere with 300cc saline implants placed beneath the muscle. She complains that they are droopy and they have rippling.

You can clearly see that she is thin, and very fit with little to no body fat. She has small breasts. Her implants stretched out the skin, particularly on the lower part of the breast and this where she has extensive rippling of her saline implants. Her muscle retracted towards her clavicle so very little muscle coverage of the implant is happening. She is bottoming out on both sides, left more than right. Her nipple-areola complexes are moving off to the side as her breast skin retracts upwards and the implant moves downwards.

She is seen here after I exchanged out her saline implants for 355cc high profile silicone implants in the submuscular pocket with the use of acellular dermal matrix (ADM) to help in the reconstruction. I can feel her acellular dermal matrix along the bottom of her breasts but I can’t see it and there is no rippling.

She told me that she was questioned by an acquaintance on how is it that her breasts looks so impressive when she is so thin? In other words, how to the look so NATURAL? This is the ultimate compliment for my work.

Lessons to learn:

  1. A thicker layer of tissue on top of your implants always results in a better outcome. Think cover over an implant, particularly a large implant, is prone for issues.
  2. Saline implants ripple more than silicone. We actually chose a larger implant in her case only because I had the option of using ADM which helped tremendously in her case.
  3. I built a new, stable home for her implants with the help of ADM. I could not have done this with any hope of reasonable success without it.
  4. The ADM was used to support the implant along the bottom of the breast and to stabilize the pectoralis muscle so that it would not retract further up her chest with the new, larger implants.
  5. She is wearing an excellent bra. Support is critical for a stable long lasting beautiful breast.
  6. She has stopped working on her chest muscle which I advised. No use working on your muscle when you have tremendous assets like these if you ask me.
  7. Always build a breast from a stable foundation. The implant needs to be in an optimal position and be stable before you decide to modify the shape of the overlying breast and position the nipple-areola complex.
  8. The photo with the rippling is this patient on my operating room table.
  9. Check out the pictures with her hands elevated. That is big time rippling.